Data Repository Support Success Story

Company Overview

The former Chinook Health is now part of Alberta Health Services, a partnership of 12 provincial health authorities in Alberta, Canada. AHS-Chinook Health delivers hospital, continuing and community care services from sites in 12 communities throughout the region to more than 157,000 residents.

Business Challenge

Facing the pending retirement of their MAGIC system which first went live in 1987, in 2006 Chinook converted their MAGIC application to MEDITECH Client/Server. However since application conversions do not include all historical data, many years’ worth of valuable patient clinical data and historical results would be unavailable once the MAGIC hardware was retired. Chinook wanted not only to preserve all the historical patient information, but also make it available via the Client/Server EMR application, including things like the complete text of transcribed reports (from Pathology, Radiology, etc.) that are not included in EMR. Several options were considered to preserve the historical MAGIC data, including maintaining the legacy hardware and applications, converting the data to an image archive system, and relying on the C/S Data Repository, which was already populated with the MAGIC Data Repository data, but did not have any of the non-converted historical data. For example, the DR had information about Lab module specimens and test results, but did not contain the interpretive textual comments for those same tests, since they were not part of the conversion from MAGIC to C/S.

Solution

In addition to integrating with the C/S EMR, other design requirements included the use of Microsoft development tools, minimization of code development, maintaining ease of administration and maintenance, and the delivery of information to the user via web browser with fast data access times. In the end the most cost-effective, efficient and complete solution was to augment the existing C/S DR database with data extracted from the MAGIC system and stored in a highly-indexed, static datamart which could then be reported against seamlessly using the same tools and methods as the DR. The application would be named MagicView.

Integrating with the C/S EMR and launching a browser-based report viewer from EMR were the next design challenges. Chinook had MEDITECH implement a custom change that added a single button to the main EMR screen to launch the MagicView application. When clicked, it initiates a call to Internet Explorer passing a patient Unit Number and an encryption key value. The MagicView web page (developed by Acmeware using Microsoft Visual Web Developer 2005) opens and checks the encryption key, then presents a page with two sections: a patient demographic header with identifier information including data from the most recent visit, and a menu containing an index of data available for the patient. The index is dynamically generated, based on the values from the MagicView datamart, which was populated using Blue Elm Software's OpenGate software from Chinook's MAGIC system. All historical clinical data and reports were extracted from MAGIC from the following areas and included in MagicView: Laboratory, Microbiology, Pathology, Pharmacy, Radiology and Departmental Reports. Once the user drills-down to a category and sub-category for a patient, those values are then passed to Microsoft Reporting Services (SSRS) which returns the final report via the browser window.

Both the MagicView application (which uses mouse-over controls for navigation and selection) and the final SSRS reports were made to closely resemble MAGIC's PCI application in terms of navigation and appearance, thus making the transition for Chinook's system users as easy as possible. Delivery of reports via SSRS also allows for more flexible report presentation and output, including showing and hiding detail data with a mouse click, and exporting reports to Adobe .pdf format. The underlying data structures are built in SQL Server 2000 databases and draw data seamlessly from both the existing C/S DR as well as the MagicView datamart (which reside on the same server) simultaneously and efficiently.

Conclusion

This project demonstrated how using out of the box development tools and Microsoft's standard business platform of Windows Server and SQL Server how DR information can be easily reported alongside other data sources. In addition, the inclusion of otherwise unavailable historical data from a soon-to-be retired MAGIC system allowed the preservation of patient data to present a complete clinical history, despite the implementation of a new clinical HCIS.